有三聚氰胺污染奶粉喂养史的112例3岁内患儿泌尿系结石内科治疗效果

Effects of Medical Treatment of Urinary Calculi in 112 Infants under Three Years Old with A History of Fee-ding Melamine-Contaminated Milk Powder

目的总结3岁内有三聚氰胺污染奶粉喂养史泌尿系结石患儿内科治疗效果,为临床诊治提供参考。方法有三聚氰胺污染奶粉喂养史的结石患儿112例[男73例,女39例;年龄(14.43±8.63)个月],入院后主要行补液、碱化尿液治疗(静脉滴注50 g/L碳酸氢钠0.5 mL/kg),并同时检测患儿尿液pH值,根据其变化调整用药量。对肾衰竭患儿予血液透析治疗。以内科治疗结束时情况判定疗效。结果112例患儿住院治疗3～25 d,痊愈56例,有效49例,无效7例。痊愈、有效及无效组患儿入院时B超测定结石直径分别为(4.77±3.16)mm、(8.13±3.79)mm和(6.92±2.65)mm,尿pH值分别为5.64±0.11、5.75±0.10和6.38±0.31。无效组尿pH平均值与痊愈组比较有明显差异(P<0.05)。排出的结石最大直径为6 mm。0～3个月、4～6个月、7～12个月和13～36个月组间疗效比较无显著差异(P>0.05)。结论3岁内有三聚氰胺污染奶粉喂养史泌尿系结石患儿内科治疗效果较好。疗效与治疗前结石大小和尿液pH值有关,与年龄无关。

Objective To summarize the effects of medical treatment of urinary calculi in 112 infants under 3 years old with a history of feeding melamine -contaminated milk powder. Methods All the infants with a history of feeding melaminecontaminated milk powder[73 male,39 females;aged （14.43 ± 8.63） months] were diagnosed with type -B ultrasonic, and through the main treatment procedures were 50 g/L sodium bicarbonate （0.5 mL/kg,iutrarenous injection） and fluid infusion. The dosage of drugs were timely adjusted according to the monitored uine pH. Hemodialysis was performed in the patients with renal failure. These were decided on the basis of the effect of medical treatment. Results During their hospitalization of 3 to 25 days,56 cases obtained full response ,49 cases showed partial response and 7 cases demonstrated no response. The mean diameters of calculi were （ 4.77 ± 3.16） mm, （8.13 ± 3.79 ） mm and （6.92 ± 2.65） mm, and the average pH values were 5.64 ± 0.11,5.75 ± 0.10 and 6.38 ± 0.31 in full response,partial response and no response groups, respectively. The average pH value in no response group was significantly higher than that in full response group （ P 〈 0.05 ）. The maximum diameter of stones discharged sucessfully was 6 mm. Different age groups （0 -3 months ,4 -6 months,7 - 12 months and 13 -36 months） had no significant difference in treatment response （ P 〉 0.05 ）. Conclusions Medical treatment can help to obtain considerable therapeutic effects for infants under 3 years old with urinary melamine calculi. Treatment response has shown partial relationship with the size of urinary calculi and pretreatment urine pH ,while no relationship is found to be related to infants＇ age.